Body composition paradox: high muscle mass and adiposity jointly predict incident chronic kidney disease in a Korean cohort

IF 2.4 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Clinics Pub Date : 2026-01-01 Epub Date: 2026-03-12 DOI:10.1016/j.clinsp.2026.100879

Eun Young Lee , Choon Hee Chung , Tae Hwa Go , Sang Baek Koh , Jung Ran Choi

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引用次数: 0

Abstract

Objective

Diabetes, hypertension, and obesity are common traditional risk factors for Chronic Kidney Disease (CKD). In this population-based longitudinal study, the authors identified risk factors associated with CKD development.

Method

A total of 6,238 Korean adults aged 40- to 69-years without baseline CKD were included. Among them, 4,057 participants with baseline estimated Glomerular Filtration Rate (eGFR) measurements were analyzed. Logistic regression models were used to evaluate significant predictors of CKD.

Results

Over a 10-year follow-up period, CKD developed in 354 subjects (8.7 %). Leptin levels were significantly higher in participants who developed CKD compared to those who did not (8.89 ± 8.00 vs. 6.44 ± 5.52, p < 0.001). After adjusting for confounding factors, logistic regression analysis indicated that participants in the highest quartile of muscle mass were 2.314-times more likely to develop CKD compared to those in the lowest quartile (Odds Ratio [OR = 2.314]; 95 % Confidence Interval [95 % CI: 1.372–3.902]; p = 0.014). In multivariable-adjusted models, the OR for incident CKD when comparing the lowest to the highest quartiles of body fat was 2.166 in men; however, the significance disappeared after adjusting for eGFR. Among women, higher leptin levels and lower adiponectin levels were independently associated with incident CKD (p = 0.003 and p = 0.038, respectively), regardless of traditional CKD risk factors. Furthermore, compared to subjects without CKD, those with metabolic syndrome had an OR (95 % CI) of 5.256 (2.813–9.820) for incident CKD after controlling for confounding factors.

Conclusion

These findings suggest that muscle mass and body fat may serve as better predictors of incident CKD.

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身体成分悖论：高肌肉量和肥胖共同预测韩国队列慢性肾脏疾病的发生

目的：糖尿病、高血压和肥胖是慢性肾脏疾病（CKD）常见的传统危险因素。在这项以人群为基础的纵向研究中，作者确定了与CKD发展相关的危险因素。方法：6238名40 ~ 69岁无CKD基线的韩国成年人纳入研究。其中，4057名参与者进行了基线肾小球滤过率（eGFR）估计分析。采用Logistic回归模型评估CKD的重要预测因素。结果在10年的随访期间，354名受试者（8.7%）发生CKD。发生CKD的受试者瘦素水平明显高于未发生CKD的受试者（8.89±8.00 vs. 6.44±5.52,p < 0.001）。在调整了混杂因素后，logistic回归分析表明，肌肉质量最高四分位数的参与者发生CKD的可能性是肌肉质量最低四分位数参与者的2.314倍（优势比[OR = 2.314]； 95%可信区间[95% CI: 1.372-3.902]; p = 0.014）。在多变量调整模型中，当比较身体脂肪最低和最高四分位数时，男性发生CKD的OR为2.166；但在调整eGFR后，其显著性消失。在女性中，无论传统的CKD危险因素如何，较高的瘦素水平和较低的脂联素水平与CKD事件独立相关（p = 0.003和p = 0.038分别）。此外，与没有CKD的受试者相比，在控制混杂因素后，代谢综合征患者发生CKD的OR （95% CI）为5.256（2.813-9.820）。结论肌肉质量和体脂可能是CKD发生的较好预测因子。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinics 医学-医学：内科

CiteScore

4.10

自引率

3.70%

发文量

129

审稿时长

52 days

期刊介绍： CLINICS is an electronic journal that publishes peer-reviewed articles in continuous flow, of interest to clinicians and researchers in the medical sciences. CLINICS complies with the policies of funding agencies which request or require deposition of the published articles that they fund into publicly available databases. CLINICS supports the position of the International Committee of Medical Journal Editors (ICMJE) on trial registration.